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HF808 • 2026

A bill for an act relating to managed care organization chargebacks and third-party auditors.

A bill for an act relating to managed care organization chargebacks and third-party auditors.

Passed Legislature

This bill passed both chambers and reached final enrollment, even if later executive action is not shown here.

Sponsor
RINKER
Last action
2025-03-06
Official status
Introduced, referred to Commerce. H.J. 539 .
Effective date
Not listed

Plain English Breakdown

Using official source text because the generated explanation was unavailable or could not be confirmed against the official bill text.

A bill for an act relating to managed care organization chargebacks and third-party auditors.

A bill for an act relating to managed care organization chargebacks and third-party auditors.

What This Bill Does

  • A bill for an act relating to managed care organization chargebacks and third-party auditors.

Limits and Unknowns

  • This entry is temporarily using official source text because the generated explanation could not be confirmed against the official bill text during the last sync.

Bill History

  1. 2025-03-06 Iowa Legislature

    Introduced, referred to Commerce. H.J. 539 .

Official Summary Text

A bill for an act relating to managed care organization chargebacks and third-party auditors.

Current Bill Text

Read the full stored bill text 
House

File

808

-

Introduced

HOUSE

FILE

808

BY

RINKER

A

BILL

FOR

An

Act

relating

to

managed

care

organization

chargebacks

and

1

third-party

auditors.

2

BE

IT

ENACTED

BY

THE

GENERAL

ASSEMBLY

OF

THE

STATE

OF

IOWA:

3

TLSB

1970YH

(3)

91

lh/ko

H.F.

808

Section

1.

NEW

SECTION

.

249A.14

Managed

care

organizations

1

——

chargebacks.

2

1.

A

managed

care

organization

acting

pursuant

to

a

contract

3

with

the

department

to

administer

the

medical

assistance

4

program

under

this

chapter

shall

not

issue

a

chargeback

to

a

5

provider

more

than

twelve

months

from

the

date

the

managed

care

6

organization

provided

reimbursement

to

the

provider.

7

2.

A

managed

care

organization

acting

pursuant

to

a

8

contract

with

the

department

to

administer

the

medical

9

assistance

program

under

this

chapter

shall

negotiate

a

fee

10

with

a

third-party

auditor

prior

to

the

third-party

auditor

11

initiating

an

audit

of

a

provider

on

behalf

of

the

managed

12

care

organization.

A

managed

care

organization

shall

not

base

13

the

managed

care

organization’s

compensation

to

a

third-party

14

auditor

on

the

percentage

of

chargebacks

identified

by

the

15

third-party

auditor.

16

EXPLANATION

17

The

inclusion

of

this

explanation

does

not

constitute

agreement

with

18

the

explanation’s

substance

by

the

members

of

the

general

assembly.

19

This

bill

requires

a

managed

care

organization

(MCO)

acting

20

pursuant

to

a

contract

with

the

department

of

health

and

human

21

services

to

administer

the

medical

assistance

program

to

issue

22

a

chargeback

to

a

provider

within

12

months

from

the

date

the

23

MCO

provided

reimbursement

to

the

provider.

24

The

bill

requires

an

MCO

to

negotiate

a

fee

with

a

25

third-party

auditor

(auditor)

prior

to

the

auditor

initiating

26

an

audit

of

a

provider.

An

MCO

shall

not

base

compensation

for

27

an

auditor

on

the

percentage

of

chargebacks

identified

by

the

28

auditor.

29

-1-

LSB

1970YH

(3)

91

lh/ko

1/

1